One year ago, the United States marked a turning point for health care cost transparency with a new law aimed at helping Americans avoid unnecessary, unexpected medical debt. As of Jan. 1, 2022, health care providers and insurers are no longer allowed to sideswipe privately insured people with bills for out-of-network services. Experts say the bipartisan No Surprises Act was a rare victory for patients and the public against exploitative health care costs, but that challenges remain. In 2019, Republicans and Democrats in Congress worked together to craft legislation that ultimately became the No Surprises Act. The  law protects people  in group and individual health insurance plans from receiving unexpected bills from out-of-network providers who cared for them at in-network facilities – a system already in place for Medicaid and Medicare patients. An independent dispute resolution process now allows insurance companies and providers to figure out coverage and costs after a patient h

  New legislation, as well as changes in patient expectations, present a host of challenges and opportunities for getting paid for service this year. In a recent article in  Physician’s Practice , we discussed the challenges surrounding  getting paid for telehealth this year and beyond . This is an essential issue for independent practices, but it’s not the only one. New legislation, as well as changes in patient expectations, present a host of challenges and opportunities for getting paid for service this year. E/M Office and Outpatient Guidelines Changes For the first time in more than two decades, the AMA has revised the guidelines for office and outpatient visit evaluation and management (E/M) codes. It’s been a long time coming—effective this year, CMS has aligned E/M coding with the changes adopted by the AMA. For many providers, this means an increase in their revenue because they will finally be compensated for time spent in activities related to patient care that were previous